School Programs Registration Form

Today's Date *

Enter today's date (e.g. July 18, 2019)

Program or Tour Requested (select one) *

Preferred Dates and Times of Visit *

Please indicate a broad range of dates that your class would be available. Also list dates you would not be available (Example: Every Wednesday, except 11/23, 12/21, 12/28. Or, any weekday September through December 21). We will do our best to accommodate your requests, but do reserve programs on a first come, first served basis, with schools from San Jose and Santa Clara County getting first preference. Out-of-county schools will be placed on the waiting list and offered a date as space becomes available. Registrations must have teacher contact information for each class registered on this form. Each registration must include the name of each teacher registering for this program and the teacher’s contact number.

School Name *

School Address (include street, city, zip) *

School Phone (include area code) *

Teacher's Name *

First

Last

Teacher's Daytime Phone (include area code) *

Teacher's Evening Phone (include area code) *

Teacher's Email *

Email

Confirm Email

Grade Level *

Number of classes *

Number of students in each class *

Number of chaperones for each class *

How will your class be arriving? *

Your contact information, e-mail, etc. if different from the teacher. (Please note, all correspondence will be with the teacher.)